JOHN A. LOGAN COLLEGE
700 Logan College Drive
Carterville, IL 62918
Phone: 618-985-2828 Fax: 618-985-4433
DUAL ENROLLMENT REGISTRATION FORM
NAME: S.S. or JALC STUDENT ID #:
Last First M.I.
ADDRESS: PHONE #:
Street Address .
E-MAIL:
City State Zip Code
BIRTH DATE: __________ GENDER: Male Female YEAR OF HIGH SCHOOL GRADUATION:
GRADE LEVEL: Sophomore Junior Senior
HIGH SCHOOL: Carbondale Du Quoin Johnston City Trico
Carterville Elverado Marion West Frankfort
Crab Orchard Herrin Murphysboro Other
Course Enrollment
SEMESTER and YEAR: ______FALL ______SPRING ______SUMMER
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DROP
COURSE
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COURSE # SECTION #
CREDIT
HOURS
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COURSE # SECTION #
CREDIT
HOURS
Please read and initial the following statements:
I understand that I am responsible for paying all tuition in excess of 8 credit hours and all fee charges by the
posted due date.
I understand that I must contact the Dual Credit Office or my guidance counselor to make any schedule changes.
I understand that I am subject to all privileges and policies in the Dual Credit Student Handbook.
I understand that grades for my dual credit courses are recorded permanently on my John A. Logan transcript
and that performance in dual credit courses may have implications on future financial aid eligibility. See the Dual
Credit Student Handbook on the JALC website for additional information.
Some courses may have content that is graphic, violent, or mature in nature; however, this content is directly
related to the course curriculum. Please discuss any questions or concerns about exposure to sensitive material
with the course instructor.
I waive the right to privacy and grant John A. Logan College officials permission to share information regarding
my performance with my parents, legal guardians and/or high school personnel.
_____________________________________________
Student Signature DATE
_____________________________________________
H.S. Principal or Counselor Signature DATE
_____________________________________________
DC/DE Director Signature DATE
Office Use Only:
BICE
Test Scores
Transcript
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Dual Credit and Dual Enrollment Courses, continued
Time eligibility chart for qualified students entering the Dual Credit/Dual Enrollment Program:
Entering the program fall of sophomore year 8 consecutive semester eligibility
Entering the program spring of sophomore year 7 consecutive semester eligibility
Entering the program the summer before junior year 6 consecutive semester eligibility
Entering the program fall of junior year 5 consecutive semester eligibility
Entering the program spring of junior year 4 consecutive semester eligibility
Entering the program summer before senior year 3 consecutive semester eligibility
Entering the program fall of senior year 2 consecutive semester eligibility
Entering the program spring of senior year 1 semester eligibility
This chart is informational and may be modified if the Illinois Community College Board changes enrollment status
requirements for additional student groups.
__________________Student Initial
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